Health Care Service Corp. v. Walgreen Co.

2023 IL App (1st) 230547, 249 N.E.3d 481
CourtAppellate Court of Illinois
DecidedAugust 30, 2023
Docket1-23-0547
StatusPublished
Cited by4 cases

This text of 2023 IL App (1st) 230547 (Health Care Service Corp. v. Walgreen Co.) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Health Care Service Corp. v. Walgreen Co., 2023 IL App (1st) 230547, 249 N.E.3d 481 (Ill. Ct. App. 2023).

Opinion

2023 IL App (1st) 230547

FIRST DISTRICT THIRD DIVISION August 30, 2023

No. 1-23-0547

HEALTH CARE SERVICE CORPORATION, a ) Appeal from the Mutual Legal Reserve Company, ) Circuit Court ) Cook County. Plaintiff, ) ) v. ) ) No. 21 L 000621 WALGREEN COMPANY and WALGREENS BOOTS ) ALLIANCE, INC., ) ) Defendants and Third-Party Plaintiffs-Appellants ) ) ) ) (Prime Therapeutics LLC, ) Honorable ) Caroline K. Moreland, Third-Party Defendant-Appellee). ) Judge Presiding.

PRESIDING JUSTICE McBRIDE delivered the judgment of the court, with opinion. Justices Reyes and Van Tine concurred in the judgment and opinion.

OPINION

¶1 This appeal case arises from the circuit court’s order staying two indemnification counts

filed by third-party plaintiffs/defendants, Walgreen Company and Walgreens Boots Alliance,

Inc. (collectively, Walgreens), against third-party defendant, Prime Therapeutics LLC (Prime).

In the underlying action, plaintiff, Health Care Services Corporation (HCSC), filed a complaint

seeking damages for fraud, fraudulent nondisclosure, unjust enrichment, and related claims based

on allegations that Walgreens had engaged in a knowing and intentional scheme of improperly

reporting artificially inflated rates for prescription drugs dispensed to persons who had health No. 1-23-0547

insurance through HCSC. HCSC further alleged that Walgreens inflated prices on millions of

claims and obtained inflated reimbursements from HCSC.

¶2 Walgreens filed the third-party complaint at issue against Prime seeking contribution and

indemnification for any judgment entered against Walgreens in the underlying action. Prime

filed a motion to dismiss the third-party complaint under sections 2-615 and 2-619 of the Code of

Civil Procedure (735 ILCS 5/2-615, 2-619 (West 2020)). The trial court dismissed the

contribution counts with prejudice and stayed the indemnification counts until HCSC’s claims

are resolved in the underlying action. 1

¶3 Walgreens appeals, arguing that the trial court erred in staying its indemnity claims for

several reasons: (1) the stay was against the public policy of simultaneous adjudication of third-

party claims with the underlying claim, (2) the court improperly held that a stay was mandatory,

(3) Prime did not properly move for a stay, (4) Prime failed to satisfy its burden by clear and

convincing evidence, and (5) Walgreens’s anticipatory repudiation claim is ripe for adjudication

and not contingent on the resolution of the underlying claim.

¶4 Multiple cases have been filed against Walgreens related to the alleged misrepresentation

of drug reimbursement prices, including the underlying case here and a consolidated federal case

filed in the District Court for the Northern District of Illinois. See BCBSM, Inc. v. Walgreen Co.,

No. 20 C 1853, 2022 WL 393596 (N.D. Ill. Feb. 9, 2022). In the federal case, Walgreens also

filed a third-party complaint alleging contribution and indemnification against Prime, which the

district court dismissed in February 2022. See id. Specifically, the court found the

indemnification counts were premature because Walgreens had not yet incurred any liability in

the underlying case. Id. at *10.

The contribution counts are not part of the appeal and thus are only discussed as necessary for an 1

understanding of this appeal. 2 No. 1-23-0547

¶5 HCSC filed its complaint against Walgreens in January 2021. HCSC administers and

underwrites health plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. Walgreens

has been a network pharmacy for HCSC, which means that members of HCSC’s health plans

could use their prescription drug benefits at Walgreens stores and receive in-network pricing.

Walgreens also offers a “Prescription Savings Club” (PSC) program, which makes prescription

drugs more affordable for uninsured and underinsured consumers in the PSC.

¶6 When Walgreens dispenses a prescription to a health plan member, an electronic claim

for reimbursement is sent to an intermediary, a pharmacy benefit manager (PBM). The PBM

would then submit a claim for payment to HCSC. Prime was the PBM at all relevant times in the

underlying action, which meant that HCSC paid Walgreens through Prime. HCSC alleged that

Walgreens made false statements and omitted material facts about its usual and customary

(U&C) prices, i.e., the cash price of a prescription drug paid by an individual without insurance.

The U&C price is the ceiling for a prescription drug. HCSC contended that Walgreens should

have included the prices available to PSC members. HCSC further alleged that Walgreens

knowingly and intentionally submitted inflated U&C prices for brand and generic drugs

purchased by HCSC’s members and caused hundreds of millions of dollars in excess

reimbursements to be paid on claims from Walgreens. The underlying action remains pending in

the circuit court.

¶7 In May 2022, Walgreens filed its third-party complaint for contribution and

indemnification against Prime. Walgreens alleged that Prime was a joint tortfeasor in the

underlying fraud claims and shares responsibility for some or all of HCSC’s harm. As HCSC’s

intermediary, Prime adjudicates Walgreens’s reimbursement claims on HCSC’s behalf and

determines each claim’s appropriate disposition under the health plan’s coverage standards.

3 No. 1-23-0547

Walgreens further asserted that it “neither transmits its U&C prices directly to [HCSC] nor

receives reimbursements directly from [HCSC].” Walgreens transmits a U&C price and other

claim-related information to Prime, Prime then allegedly transmits a U&C price and other claim-

related information to HCSC, HCSC sends a reimbursement to Prime, and finally Prime sends

the reimbursement to Walgreens.

¶8 Walgreens further alleged that due to its role as the intermediary, Prime knew and

understood how both Walgreens and HCSC defined U&C prices and how much HCSC paid

Walgreens for any reimbursement claims. The third-party complaint asserted that Prime was

aware of Walgreens’s U&C price reporting policies and practices and adjudicated Walgreens’s

reimbursement claims using Walgreens’s allegedly false U&C prices, proximately harming

HCSC and contributing to HCSC’s loss.

¶9 The third-party complaint alleged multiple counts for contribution and indemnification,

including five counts for contribution (one count for each state in which HCSC operates, i.e.,

Illinois, Oklahoma, Texas, New Mexico, and Montana) and two counts for indemnification, one

seeking a declaratory judgment and the other based upon a claim of anticipatory repudiation.

Since this appeal only involves the indemnification counts, we address the allegations in the

complaint for those two counts.

¶ 10 Both the declaratory judgment and anticipatory repudiation indemnification counts are

based on the same allegations. The relationship between Walgreens and Prime is governed by a

contract, dated March 1, 2008 (2008 contract). Section 8.2 of the 2008 contract contains an

indemnification clause in which Prime agreed to:

“indemnify and hold [Walgreens] harmless from and against all claims or suits

asserted by a third party(ies) and related losses, damages and expenses, including

4 No. 1-23-0547

but not limited to reasonable attorney[ ] fees, costs and expenses to the extent they

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Nicholas G v. Endeavor Health Clinical Operations
2026 IL App (2d) 250425-U (Appellate Court of Illinois, 2026)
Stangarone v. Endeavor Health Clinical Operations
2026 IL App (2d) 250425-U (Appellate Court of Illinois, 2026)
Bickett v. Van Winkle
2025 IL App (5th) 241215-U (Appellate Court of Illinois, 2025)
Anderson v. Kamide
2024 IL App (3d) 240047-U (Appellate Court of Illinois, 2024)
Progressive Universal Insurance Co. v. Lonsdale
2024 IL App (5th) 231170-U (Appellate Court of Illinois, 2024)

Cite This Page — Counsel Stack

Bluebook (online)
2023 IL App (1st) 230547, 249 N.E.3d 481, Counsel Stack Legal Research, https://law.counselstack.com/opinion/health-care-service-corp-v-walgreen-co-illappct-2023.